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Abortion Clinics Close at Record Pace After States Tighten Rules

At least 58 U.S. abortion clinics --
almost 1 in 10 -- have shut or stopped providing the procedure
since 2011 as access vanishes faster than ever amid a
Republican-led push to legislate the industry out of existence.

A wave of regulations that makes it too expensive or
logistically impossible for facilities to remain in business
drove at least a third of the closings. Demographic changes,
declining demand, industry consolidation, doctor retirements and
crackdowns on unfit providers were also behind the drop. More
clinics in Texas and Ohio are preparing to shut as soon as next
month.

Anti-abortion demonstrators pray
in the Texas State Capitol building in Austin, Texas, on July 1, 2013.
Photographer: Erich Schlegel/Getty Images

Opponents have tried to stop access to abortion through
civil disobedience, blockades and legal action. Clinics were
bombed and doctors killed. Now, legislatures are proving to be
the most effective tool after Republicans made historic gains in
the 2010 elections. Their success is creating one of the biggest
shifts in reproductive health care since the Supreme Court’s Roe
v. Wade decision in 1973 legalized abortion in all 50 states.

“People who don’t have power protest on the street,” said
Cheryl Sullenger, senior policy adviser at Operation Rescue, an
anti-abortion group based in Wichita, Kansas. “People who have
influence work from within to enact change.”

Thinning Ranks

Clinics, not doctors’ offices or hospitals, are where most
women go to terminate pregnancies. The ranks of the facilities
have been thinning since the late 1980s, when the number of
large nonhospital providers -- those performing 400 or more
abortions per year -- peaked at 705, according to the Guttmacher
Institute, a New York-based reproductive-health research
organization. By 2008, the most recent year for which data are
available, that number had fallen to 591.

The pace began accelerating in 2011. Since then, through
Aug. 1 of this year, state lawmakers passed 200 abortion
restrictions, according to Guttmacher. That’s about the same
number that had passed in the prior 10 years combined.

In July, Republican Governor Rick Perry signed a bill
making Texas the largest and most populous state to pass
comprehensive clinic regulations. The law requires abortion
facilities to become outpatient surgical centers and their
doctors to have admitting privileges at nearby hospitals. Though
the law won’t take effect until October, three clinics have
already shut because of it, bringing closings there to at least
six since 2011.

100 Miles

Planned Parenthood Center for Choice in Bryan, which
stopped seeing patients the first week of August, was one of
them. A message on its website now directs would-be patrons to a
facility in Houston, about 100 miles (161 kilometers) away.

“Due to the recent passage of politicized health-care
restrictions in Texas House Bill 2, women will lose access to
safe abortion services in Brazos County,” it says. “While we
believe the excessive and medically unnecessary requirements
imposed on clinics providing early abortion are
unconstitutional, we have made the difficult and practical
decision to close at this time rather than face the prospect of
having to do so in the foreseeable future.”

Two Virginia clinics, including NOVA Women’s Healthcare in
Fairfax, the state’s busiest facility last year, have shut since
April, when health officials approved building rules similar to
Texas’s.

Arizona is now home to seven providers, down from 19 in
2010, after lawmakers effectively banned nurse practitioners
from providing abortions. There weren’t enough doctors to
replace them, making abortion inaccessible outside the areas of
Phoenix and Tucson, the state’s two largest cities, said Cynde
Cerf, a spokeswoman for the local Planned Parenthood affiliate.

Fighting Back

Across the nation, the number of closings would probably be
higher were it not for legal fights that have prevented some
laws from taking effect. The sole clinics in North Dakota and
Mississippi, for instance, remain open after courts temporarily
blocked requirements that their doctors gain hospital
privileges.

Texas, Kansas, Louisiana, and Arizona have each seen one
new clinic open since 2010.

Anti-abortion forces often claim credit for clinic
closings, celebrating them as moral victories that double as
evidence that their goal of eliminating the practice is working.

Operation Rescue’s Sullenger says she’s persuaded 40
abortion providers to quit, and that her sidewalk counseling
ministry has saved more than 2,500 lives. The group, which
operates out of a former clinic that it bought and closed in
2006, gained notice in the 1990s after leading demonstrations
that led to hundreds of arrests. Sullenger spent two years in
federal prison after pleading guilty to conspiring to gasoline-bomb a clinic in 1987.

Project Daniel

In 2009, the group introduced Project Daniel 5:25, “named
after the biblical story of Daniel, who was able to read the
handwriting on the wall and predict the fall of a wicked
kingdom,” to determine the location of every clinic in the U.S.
Now housed at www.abortiondocs.org, the addresses of current and
former clinics are listed beside photos of doctors and owners.

It’s one of most comprehensive tallies, referenced by
supporters and opponents of abortion rights alike. Using it as a
starting point, Bloomberg verified at least 58 clinics that
closed or ceased providing abortions in 24 states through phone
calls to current and former area providers, information from
state health officials and local news reports. Those that
couldn’t be confirmed or were listed erroneously -- meaning they
are in fact open or weren’t abortion providers -- weren’t
included in the final count.

Record Pace

The reporting by Bloomberg, coupled with data from
Guttmacher, which surveys providers every few years, show that
clinics have closed at a record pace since 2011. During the past
three years, an average of 19 closed each year. That’s more than
double the rate in the decade ending in 2008.

Not all closings resulted from state laws. Internal funding
issues drove the Family Planning Association of Maine to shut
its South Portland location last year, said Nancy Audet, a
spokeswoman. The Bours Health Center in Eugene, Oregon, ceased
operation this year after its doctor retired, according to the
National Abortion Federation, a trade association with 400
members in the U.S., Canada and Mexico.

In some cases, closings brought relief to both sides of the
debate. Gone are two Pennsylvania clinics with ties to Steven
Brigham, a doctor accused repeatedly of substandard care and
barred from practicing medicine in that state.

Natural Changes

Part of the decrease in providers reflects natural changes
in the marketplace, said Vicki Saporta, the federation’s
president and chief executive officer. One bright spot, she
said, is the number of private practitioners offering abortion-inducing drugs, which has climbed since the Food and Drug
Administration approved them in 2000. Increased contraception
use and the development of more effective methods have also
pushed down unplanned pregnancy and abortion rates.

Still, the shrinking pool of clinics has raised concerns
that a woman’s constitutional right to an abortion increasingly
depends on whether she has money for travel.

“It’s disheartening beyond words,” said Renee Chelian,
who opened her first clinic in suburban Detroit in 1976. She now
owns three there that she’s fighting to keep open after the
state legislature passed building regulations last year.

Fourteen clinics in Michigan and neighboring Ohio have shut
in the past three years, prompting Chelian to add clinic hours
and hire another physician to meet increased demand.

One of them was American Family Planning Inc. in Dearborn,
less than 30 miles south of her facilities. In June, 160
activists gathered outside it to “pay tribute to the thousands
of unborn children aborted there,” according to Citizens for a
Pro-Life Society, based in nearby South Lyon.

Photos on the group’s website show “flowers for the dead”
and a yellow-beaded rosary that participants left behind.

“May the blood of Christ triumph over all such places of
death,” the caption reads.

Washington, DC -- The American Congress of Obstetricians and Gynecologists (ACOG) believes physicians who provide medical and surgical procedures, including abortion services, in their offices, clinics, or freestanding ambulatory care facilities should have a plan to ensure prompt emergency services if a complication occurs and should establish a mechanism for transferring patients who require emergency treatment. However, ACOG opposes legislation or other requirements that single out abortion services from other outpatient procedures. For example, ACOG opposes laws or other regulations that require abortion providers to have hospital admitting privileges. ACOG also opposes facility regulations that are more stringent for abortion than for other surgical procedures of similar low risk.

You didn't answer my question, you deflected. Cheryl Sullenger tried to blow up a women's health clinic. Her phone number was found on Scott Roeder's dashboard after he murdered Dr. Tiller - she was keeping him updated on Tiller's whereabouts.

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